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Cited by 340

The DOI matches its Crossref record; 11 of the 11 references it cites were found in a registry or an index.

Utility of Combinations of Biomarkers, Cognitive Markers, and Risk Factors to Predict Conversion From Mild Cognitive Impairment to Alzheimer Disease in Patients in the Alzheimer's Disease Neuroimaging Initiative

Gomar, Jesus J.·2011·Archives of General Psychiatry
DOI 10.1001/archgenpsychiatry.2011.96
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Abstract

CONTEXT: Biomarkers have become increasingly important in understanding neurodegenerative processes associated with Alzheimer disease. Markers include regional brain volumes, cerebrospinal fluid measures of pathological Aβ1-42 and total tau, cognitive measures, and individual risk factors. OBJECTIVE: To determine the discriminative utility of different classes of biomarkers and cognitive markers by examining their ability to predict a change in diagnostic status from mild cognitive impairment to Alzheimer disease. DESIGN: Longitudinal study. PARTICIPANTS: We analyzed the Alzheimer's Disease Neuroimaging Initiative database to study patients with mild cognitive impairment who converted to Alzheimer disease (n = 116) and those who did not convert (n = 204) within a 2-year period. We determined the predictive utility of 25 variables from all classes of markers, biomarkers, and risk factors in a series of logistic regression models and effect size analyses. SETTING: The Alzheimer's Disease Neuroimaging Initiative public database. OUTCOME MEASURES: Primary outcome measures were odds ratios, pseudo- R(2)s, and effect sizes. RESULTS: In comprehensive stepwise logistic regression models that thus included variables from all classes of markers, the following baseline variables predicted conversion within a 2-year period: 2 measures of delayed verbal memory and middle temporal lobe cortical thickness. In an effect size analysis that examined rates of decline, change scores for biomarkers were modest for 2 years, but a change in an everyday functional activities measure (Functional Assessment Questionnaire) was considerably larger. Decline in scores on the Functional Assessment Questionnaire and Trail Making Test, part B, accounted for approximately 50% of the predictive variance in conversion from mild cognitive impairment to Alzheimer disease. CONCLUSIONS: Cognitive markers at baseline were more robust predictors of conversion than most biomarkers. Longitudinal analyses suggested that conversion appeared to be driven less by changes in the neurobiologic trajectory of the disease than by a sharp decline in functional ability and, to a lesser extent, by declines in executive function.

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Metadata

Authors
Gomar, J. J.
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2011-09-01
Volume
68
Issue
9
Pages
961
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archgenpsychiatry.2011.96
OpenAlex
W1976817527
Cited by
340
References
11
FWCI
18.32
Type
journal article
Language
en
Open access
closed

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